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Varicose Veins

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Varicose veins are usually bulging veins running just beneath your skin surface

Varicose veins are usually bulging veins running just beneath your skin surface. The veins often appear on the legs and feet. Development occurs when the valve in the veins stops functioning properly and allows blood backflow. Superficial varicose veins spider veins are visible swollen and twisted veins surrounded by flooded capillaries patches. Getting varicose veins treatment can bring relief to the pain.

Deep varicose veins are not visible but tend to cause aching or swelling throughout the affected limb, and sometimes, blood clots can develop. When inflamed, these veins become tender to touch. They also impede blood flow causing itchy skin, aching, and swollen ankles in the affected limb. In severe cases, these veins may rupture, leading to varicose ulcers on the skin. Besides the visibly swollen veins, on rare occasions, interior leg veins can also become varicose.

It’s best to get medical care in the early stages of varicose veins and avoid further damages with preventative care.

What Causes Varicose Veins?

Varicose veins mainly occur when the valve inside the veins fails to function appropriately. Healthy veins allow blood to flow smoothly back to the heart. The blood backflow is prevented by small valves that open and close to allow the blood to flow forward. In some instances, the weakness or absence of the veins causes the blood to flow backward. The blood collects in the vein, causing it to be swollen/enlarged.

In other scenarios, the vein wall weakness can also cause the pooling of blood. When the veins become weak, they are unable to push blood back to the heart. This causes the blood volume in the blood vessels to increase, leading to varicose veins. Some of the other less common causes include;

  • Inflammation of the veins (phlebitis)
  • Congenital abnormalities of the veins
  • Blood clots and other conditions that may obstruct the flow of blood in the veins

Varicose Veins – Risk Factors

While varicose veins can affect both men and women at any stage of life, the following factors increase your risk of developing this condition.

Varicose vein risk increases with age. As we age, the valves in the veins become weak. The wear and tear will eventually allow the blood to leak back into the vein where it collects instead of flowing upwards to the heart.

Various studies show that women are more susceptible to varicose veins than men are. Hormonal changes during pregnancy or before the menstrual period cause the veins’ walls to relax, leading to blood backflow. Additionally, hormone treatment such as birth control pills can also increase your susceptibility to this condition.

The hormonal changes during pregnancy can also increase the risk for varicose veins. When you become pregnant, the blood volume in the body increases to help support the growing fetus. Unfortunately, the increased blood might be too much for your veins to push back to the heart from your feet, resulting in enlarged veins.

A sedentary lifestyle that involves standing or sitting for an extended period without movement or exercising may lead to improper blood circulation.

Being overweight exerts too much pressure on the veins, making it hard for them to push the blood to your heart.

Research also shows that individuals from a family with a history of varicose veins have an increased chance of contracting the condition.

Varicose Veins – Diagnosis

The diagnosis is usually simple since it is easily visible. The doctor will also perform a physical examination to assess the extent of the condition. Here, your physician may also ask you to describe any aching and pain in your limb. You may also need an ultrasound test to check how the veins are functioning or a blood clot restricting the blood flow. Another standard test is the plethysmography test that checks how the affected veins work by measuring the blood that flows through the veins.

Varicose Veins Complications

Although rare, varicose veins complications can also arise. Some of the common complications include;

Non-healing Ulcers

Sometimes, varicose veins lead to painful ulcers that form on the skin near the affected veins and ankles. Before forming the ulcer, you will note a discolored spot that deteriorates to become a painful non-healing ulcer. In case you suspect the formation of an ulcer, seek medical intervention immediately.

Blood Clots

Chronic inflammation in your legs warrants medical attention as it most often indicates a blood clot. Blood clots (Thrombus) are dangerous as they can move up the veins, causing a stroke. When the blood pools in the veins, the affected region becomes painful and swells.


When the pressure builds up in the veins close to the skin, they eventually burst, causing minor bleeding. While the skin breakout may be minor, seeking medical attention is crucial to prevent further complications.

Varicose Veins Treatment

Treatment is crucial to ease pain and discomfort and address other swelling and leg ulcers. Other patients may also want varicose vein treatments to remove the rather unsightly varicose veins.

In mild cases, doctors are rather conservative when treating varicose veins. Your doctor will advise you to make lifestyle changes rather than undergoing aggressive treatments. The following lifestyle changes can help prevent the condition from worsening.

  • Avoid sitting or standing for long periods without any movement
  • Lose or maintain a healthy weight
  • Regular exercise to improve blood circulation
  • Elevating your legs, especially after a long day at work

Wearing special compression stockings can also help in managing varicose veins. The compression socks exert enough pressure on the leg, allowing the blood to flow easily to the heart. The socks also help to decrease swelling. The compression stockings are available in different sizes and compression levels. Your doctor will assist you in picking the model that suits your needs.

Using over-the-counter anti-inflammatory drugs such as ibuprofen or aspirin can help in alleviating the occasional pain and swelling caused by varicose veins. However, if you notice that the skin around the varicose vein is becoming discolored or the pain persists without an outwards sign, contact your doctor as this could mean that a deep vein is affected.

Medical procedures are necessary, especially for the advanced varicose veins. The most common medical procedures include:

  • Ligation and stripping

Litigation is a minimally invasive procedure that helps in treating varicose veins. The doctor will make two incisions during the procedure, one at the target vein and the other further down at your ankle or knee. The doctor then seals the top of the vein, inserts a thin, flexible wire through the vein’s bottom, and then pulls the wire out. The procedure usually does not require a hospital stay, and the patient often recovers within a few days.

  • Sclerotherapy

Sclerotherapy is another standard procedure for treating varicose veins. The procedure involves injecting a special chemical into the small and medium-sized varicose veins. This chemical usually scars and closes the problematic veins.

  • Radiofrequency ablation

In Radiofrequency ablation, the doctor will make a small incision above or below the knee with the help of an ultrasound scan. Next, the doctor will insert a probe into the catheter that creates radiofrequency energy. The radiofrequency energy creates heat that heats the vein to collapse the walls. The procedure helps in closing the vein effectively. This method is usually recommended for extensive varicose veins and is performed with local anesthesia.

  • Endovenous laser treatment

Here the doctor usually inserts a catheter into the patient’s vein. The catheter emits laser beams that deliver short energy bursts which heat and seal the affected vein. An ultrasound scan helps the doctor to thread the laser up the vein to ensure that the entire vein closes off. Similar to Radiofrequency ablation, the procedure is also performed with local anesthesia.

  • Transilluminated powered phlebectomy

A special light (endoscopic transilluminator) is threaded through son incision made into the skin, allowing the doctor to see the veins that need to be removed. The doctor then uses a suction device to cut and remove the target veins. The procedure requires the use of a local or general anesthetic. It may also cause some bruising or bleeding, but it offers excellent results, especially for extensive varicose veins.

Varicose Veins Prevention

Admittedly, currently, no proven methods prevent varicose veins ultimately. However, improving muscle tone performance and blood circulation can help reduce the risk of developing the condition and prevent the progression of the existing conditions. The following tips should also help reduce the pain and discomfort from varicose veins at your home’s comfort.

Exercise plays a significant role in boosting your blood circulation. The veins depend on the muscle contractions to push the blood up toward the heart. Regular workouts help tone these muscles, improving the blood flow.

If you are overweight or obese, you put too much stress on your legs, restricting blood circulation. Losing weight helps to prevent the formation of varicose veins. Maintaining the right weight also helps reduce the risk of type 2 diabetes, stroke, and heart disease.

Sitting at your computer desks for long hours or staying on your legs for an extended period also puts you at an increased risk of varicose veins. Taking a break after every thirty minutes will help your muscles to move blood up towards your heart.

Tight clothes can put too much pressure on your legs, worsening your condition. Loose clothes allow for optimal blood circulation, which helps in the removal of varicose veins.

Elevating your feet will help the blood flow from your legs to the heart, thanks to the gravity force. Ensure that you elevate your feet about 20 minutes every day, especially for individuals whose work involves long hours of standing or sitting.

Wearing a support pantyhose is a great preventive measure to prevent the varicose veins from forming. While these socks do not put as much pressure as the compression socks, they help blood circulation, keeping the condition at bay. Wearing a clean pair of compression socks every day will also prevent the formation or worsening of the condition. These socks put pressure on the ankle and lower leg, helping the blood to move up towards your heart.

Treatments for Varicose Veins

Unlike varicose veins, spider veins are harmless. Most people seek spider veins treatment for cosmetic reasons. However, treatment will also alleviate the mild yet persistent discomfort this condition sometimes causes.

What Causes Reticular Veins

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Veins play an integral role in the vascular and circulatory systems

Veins return deoxygenated blood from various body parts back to the heart and lungs. Unlike the arteries, veins do not use pressure to move the blood. Instead, they utilize valves and muscles to push the blood effectively.

In lower body extremities such as the feet, veins actively work against gravity to drive the blood back to the heart and lungs. However, when specific muscles and valves fail, the blood may flow back to the lower regions and pool in certain places. This can lead to various vascular issues, or chronic venous insufficiency (CVI). Reticular veins often appear as an early sign and symptom of CVI.

What are reticular veins?

Reticular veins are visible veins that appear just below the top layer of your skin. However, these veins rarely protrude from the skin. In most cases, they are about 2 mm in diameter, and it may take some time before you can notice them.

Since all veins carry oxygen-deficient blood, reticular veins may appear blue or purple. While they can appear in any part of the body, they commonly form on the inner thighs. Other places where these veins may develop include the ankles, at the back of your knees, and the general backside of the leg.

As mentioned above, reticular veins are not always easily discernible as spider veins or varicose veins. Moreover, they may appear without any accompanying symptoms. In these cases, they only cause a cosmetic concern to the affected person. People seek treatment from reticular veins as they feel uncomfortable having their legs exposed while wearing short garments like skirts, bathing suits, and shorts.

Risk factors associated with reticular veins

Reticular veins stem from venous insufficiency and weakened valves. Other conditions that emanate from venous insufficiency include spider veins and varicose veins. Some of the risk factors that may increase your chance of developing reticular veins and other venous insufficiencies include:


If your line of work requires you to sit or stand for long, you could end up developing reticular veins. Some of the professions susceptible to the condition include teachers, factory workers, nurses, and programmers. People who sit for long are especially vulnerable to reticular vein formation at the back of the knees.


Being overweight or obese increases the pressure on your lower region, especially the legs. This extra pressure can affect blood flow and reduce vein efficiency, which leads to the development of reticular veins.

Genetics and family history

If someone in your direct family line suffers from reticular veins or other vascular conditions, you, too, stand a greater chance of developing the disease.


Reticular veins become more common as people age. The older you get, the more likely you are to develop vein deficiencies, including reticular veins.


Becoming pregnant can exert pressure on your veins and constrict blood flow to and from the limbs. This increased pressure can then lead to the formation of reticular veins.

What are the common symptoms of reticular veins?

Reticular veins don’t always present symptoms and may even go unnoticed. However, you may feel an itching and prickly sensation as they begin to form. Other notable symptoms include:

  • A burning sensation
  • Aching
  • Discomfort
  • Fatigue

How dangerous are reticular veins?

Other than the symptoms mentioned above, which may or may not occur, reticular veins do not pose a significant health risk.

However, they do indicate blood flow problems in the veins. If you notice them, you should consult a vascular specialist. This will help rule out other severe vascular conditions like Varicose veins and Deep vein thrombosis (DVT).

If you are affected by reticular veins, listed below are tips to improve blood flow to your limbs:

  • Elevating your legs when seated or lying down to improve blood flow from the legs to the heart and lungs.
  • Refraining from crossing your legs when seated. This can reduce efficient blood flow to the limbs.
  • Wearing compression socks to improve blood circulation and reduce lower leg swelling is especially helpful for those who stand for long periods of time.
  • Exercising regularly improves blood flow and maintains a healthy weight.

While reticular veins are not typically harmful to your health and wellbeing, they can be an early warning sign of vascular issues. These issues may lead to the development of conditions such as varicose veins. If you’re uncomfortable with the appearance of the reticular veins or if they display any of the mentioned symptoms, you should see a vascular expert.

Can reticular veins be treated?

Various treatment options can be used to treat and manage reticular veins. Treatments may vary depending on condition severity. Some of the commonly used treatments are:

Laser therapy

Laser therapy treatment options like the Cutera Excel V laser system are commonly used to treat vascular conditions such as reticular veins. The Cutera Excel V laser was developed using feedback from leading vascular physicians around the world.

It comprises two-wavelength modes, 532 nm, and 1064 nm. It can be used on more than 20 different indications on all skin types. The Excel V system houses the broadest capabilities in treating both superficial and deep vascular conditions.

Why is laser therapy better than other reticular vein treatment options?

Most vascular specialists prefer to treat reticular veins with the Cutera Excel V laser system because it can be adjusted to match the skin condition.

Moreover, this laser treatment offers a variety of laser spot sizes. This increased precision allows for a highly-effective treatment in a short amount of time. These customization features set the Excel V system ahead of other treatment options because lengthy, complicated procedures can now be performed easily in a single session.

Other reticular veins treatment options are;



Sclerotherapy is a minimally invasive procedure. A vascular specialist will inject medication into the affected area. The medication blocks and collapses the lining of the problematic veins. An ultrasound is used to determine the best spot to inject the medication.


While this minimally invasive procedure is mainly used on varicose veins, it also treats reticular veins. Microphlebectomy surgically extracts the affected reticular veins with specialized medical equipment.

Spider Veins

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Although they may look like varicose veins

spider veins are often painless damaged veins on the legs or facial region. Most people seek treatment for for cosmetic reasons.

The veins usually appear in small webs, branches, or thin lines, which sometimes earns them the name “thread veins.”

Treatments that reduce the appearance of or altogether remove spider veins are available. First, let’s look at what causes them.

Causes of Spider Veins

What causes spider veins? They occur due to damaged valves. Veins, which carry blood to the heart, need valves to prevent the backward flow of blood. But when these one-way valves weaken or get damaged, unidirectional blood flow is disrupted. This causes blood to pool inside the vein.

Over time, this pooling blood makes the vein bulge, then branch out, leading to spider veins.

Facial spider veins often appear due to sun damage or increased pressure, which can cause tiny blood vessels to burst.

Spider Veins vs. Varicose Veins

Are spider veins the same as varicose veins? Each of these medical conditions is a form of venous insufficiency or chronic venous insufficiency. Even though they’re both caused by weakened and damaged valves, they tend to have different symptoms.

Spider veins appear as tiny, thin threads or lines that are flat or slightly raised. Varicose veins are much larger and deeper and tend to be lumpy and twisted.

Spider veins are often blue, purple, or red, whereas varicose veins are invariably red or flesh-colored.

Also, varicose veins can cause various other symptoms such as swelling, bleeding, itching, and pain. They increase the likelihood of circulatory issues and blood clots.

Risk Factors for Spider Veins

Pregnancy increases blood flow and puts extra weight on the legs. This dramatically increases the chances of pregnant women developing spider veins on the legs.

Sometimes they disappear after the pregnancy, but in some cases, they can be permanent.

90% of people who develop spider veins have a history of them in their family. The condition is usually hereditary.

Females are more likely to develop spider veins than men are.

The valves in the leg veins weaken with age, increasing the likelihood of blood pooling in the veins. Calf muscles give some support to veins, but with age, these muscles weaken too.

Estrogen weakens valves, so taking hormonal treatments for birth control or menopause increases the risk of spider veins.

Coughing, sneezing, or vomiting forcefully may give rise to spider veins. This is because excessive pressure in the face can cause blood vessels to rupture. Women are especially prone to facial spider veins during childbirth due to the pressure of pushing.

Sun damage can also cause facial spider veins when it breaks through skin and damages underlying blood vessels. Ultraviolet light can burst blood vessels, causing pooling.

Being overweight can add more pressure on leg veins, making valves more likely to malfunction.

Staying in the same position for extended periods makes it harder for veins to pump blood upwards to the heart.

When there’s already damage to the vein or a clot, the valves malfunction more easily, increasing the likelihood of spider veins occurring.

Treatments for Spider Veins

Unlike varicose veins, spider veins are harmless. Most people seek treatment for cosmetic reasons. However, treatment will also alleviate the mild yet persistent discomfort this condition sometimes causes.

Our Vascular Disease Physicians

The physicians at Pedes Orange County devote their lives to saving limbs and minimizing pain. Our conveniently located, state-of-the-art facility is designed for your comfort and utilizes cutting-edge technology to provide minimally invasive treatments. Our vascular surgeons and vascular specialists are board-certified and some of the best in Southern California. Personable staff members make every visit a positive experience, with short wait times and an efficient, streamlined process that ensures you leave feeling educated and confident that you are in good hands.

J. Joseph Hewett, M.D.

Vascular Specialist

Neil K. Goldstein, M.D.

Vascular Specialist

Derrick Tran, MD

Vascular Specialist

Mohammad Jaber, M.D.

Vascular Surgeon

Why Pedes Orange County?

A spider vein looks very different from a varicose vein, and generally, they don’t affect you like varicose veins, but they can be just as severe as varicose veins when they are in groups or clumps. Preventing this condition is possible through self-care and minor lifestyle adjustments. It’s vital to be proactive if your family has a history of the condition. Give us a call and talk to one of our specialists.

What to Expect from Your Visit to Pedes


Your treatment will begin with an ultrasound examination of your veins, arteries, or both, in your legs to diagnose the presence and extent of the disease. Your test results will be immediately available to review with the doctor.


Once we review the results of your diagnostic tests, our physicians will help you develop a plan to provide you with the best treatment for your disease.


Your treatment will begin with an ultrasound examination of your veins, arteries, or both, in your legs to diagnose the presence and extent of the disease. Your test results will be immediately available to review with the doctor.

Follow up

Your treatment will begin with an ultrasound examination of your veins, arteries, or both, in your legs to diagnose the presence and extent of the disease. Your test results will be immediately available to review with the doctor.

Treatment Options

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What to Expect

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Vascular Disease

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